Definition

Vaginal prolapse is the inward and downward bulging of the vaginal walls. It occurs when the supporting tissues of the lower pelvis weaken. The lack of support causes the walls of the vagina to weaken, sag, and collapse. Prolapse may also occur after
hysterectomy
. Other structures or organs near the vagina are also shifted. Types of vaginal prolapse include:

Cystocele
(dropped bladder)—when the collapse involves the front of the vagina and bladder

Rectocele
—when the collapse involves the back of the vagina and rectum

Enterocele—when the collapse involves the top vaginal wall and small bowel

The severity of vaginal prolapse may be defined as:

First degree—collapse into the upper part of the vagina

Second degree—collapse further into the vaginal canal, down to the level of the vaginal opening

Third degree—collapse that extends beyond the opening

Causes

Vaginal prolapse is caused by weakened support structures in the pelvic region.

Symptoms

Vaginal prolapse may not cause any symptoms. But when it does, the symptoms may include:

Vaginal pressure

A feeling of vaginal fullness or heaviness

A feeling of pulling in the pelvis

Discomfort in the vagina

Low backache that is relieved with lying down

Urinary frequency

Urination when laughing, sneezing, coughing, or exercising

Difficulty with bowel movements

Difficult or painful intercourse

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will also be done. Vaginal prolapse that has no symptoms may be diagnosed during routine gynecologic examinations. Your doctor may refer you to a gynecologist, who will do a pelvic exam.

Treatment

Talk with your doctor about the best treatment plan for you. First or second degree prolapse without symptoms may not require treatment. Treatment options include:

Kegel Exercises

Kegel exercises
involve tensing the muscles around the vagina and anus, holding for several seconds, then releasing. The repetition of this exercise will help to tone pelvic muscles.

Pessary Insertion

Your doctor may insert a pessary into the upper portion of the vagina. A pessary is a rubbery, doughnut-shaped device. It helps to prop up the uterus and bladder. Pessary placement is more often used in older women.

Surgery

Vaginal prolapse that is severe or associated with lasting symptoms may require surgery. Surgery may involve repairing the pelvic floor structure or, in some cases, to suture the vagina.

If you are diagnosed with vaginal prolapse, follow your doctor's
instructions
.

Prevention

To help prevent vaginal prolapse:

Do
Kegel exercises
.

Avoid constipation.

Maintain a healthy weight.

If you smoke,
quit
. Smoking may cause chronic coughing and weakening of connective tissues.

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY.
Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.